Hypertrophic Pyloric Stenosis in a Premature Infant: A Case Report

Hypertrophic pyloric stenosis is uncommon in premature babies. In term infants, the typical presentations include a palpable mass over the epigastric area, exaggerated gastric peristalsis after feeding and projectile non-bilious vomiting. However these symptoms are not commonly seen in premature infants. The onset of symptoms in pyloric stenosis in premature infants is later than that in term infants. The pyloric index (including pyloric wall thickness, and the length and the width of pyloric canal) measured by sonography gives a definite diagnosis in term infants. But the sonographic diagnostic criteria are unclear in premature infants. We report a case of a premature baby (gestational age of 34 weeks, birth body weight of 2,000 g, twin B) with pyloric stenosis who developed non-bilious projectile vomiting in the 3rd week of life. Pyloromyotomy was performed at 5 weeks of age with a smooth post-operative course. Feeding was started on the 3rd postoperative day and he was discharged on the 10th postoperative day with a body weight of 2,200 g.